背景:真菌感染,如曲霉属,已被发现为病毒性肺炎的常见并发症。本研究旨在通过荟萃分析确定病毒性肺炎患者真菌超感染的危险因素。
目的:本研究旨在通过Meta分析确定病毒性肺炎患者真菌感染的危险因素。
方法:我们回顾了2010年1月1日至2020年9月30日在中国生物医学文献中发表的关于病毒性肺炎患者真菌感染的主要文献,中国国家知识基础设施,万方(中国),科克伦中央图书馆,Embase,PubMed,和WebofScience数据库。这些研究进行了一系列统计分析,包括偏差风险和敏感性分析。
结果:在这项研究中,我们发现接受皮质类固醇治疗的病毒性肺炎患者与未接受皮质类固醇治疗的患者相比,真菌感染的发生率有统计学差异(p<.00001).此外,关于真菌感染的严重程度,我们观察到急性生理和慢性健康评估(APACHE)II评分较高的患者中侵袭性肺曲霉病(IPA)的发病率明显较高(p<.001),肿瘤(p=0.005),或免疫功能低下的患者(p<0.0001)。
结论:我们的研究表明,皮质类固醇治疗是病毒性肺炎患者发生真菌感染的重要危险因素。APACHEII得分高,肿瘤,免疫功能低下的状况也是发生IPA的重要危险因素。早期血清半乳甘露聚糖(GM)检测可促进病毒性肺炎患者真菌感染的诊断,支气管肺泡灌洗液曲霉菌抗原检测,文化,还有活检.
Infections with fungi, such as Aspergillus species, have been found as common complications of viral pneumonia. This study aims to determine the risk factors of fungal superinfections in viral pneumonia patients using meta-analysis.
This study aims to determine the risk factors of fungal infection s in viral pneumonia patients using meta-analysis.
We reviewed primary literature about fungal infection in viral pneumonia patients published between January 1, 2010 and September 30, 2020, in the Chinese Biomedical Literature, Chinese National Knowledge Infrastructure, Wanfang (China), Cochrane Central Library, Embase, PubMed, and Web of Science databases. These studies were subjected to an array of statistical analyses, including risk of bias and sensitivity analyses.
In this study, we found a statistically significant difference in the incidence of fungal infections in viral pneumonia patients that received corticosteroid treatment as compared to those without corticosteroid treatment (p < .00001). Additionally, regarding the severity of fungal infections, we observed significant higher incidence of invasive pulmonary aspergillosis (IPA) in patients with high Acute Physiology and Chronic Health Evaluation (APACHE) II scores (p < .001), tumors (p = .005), or immunocompromised patients (p < .0001).
Our research shows that corticosteroid treatment was an important risk factor for the development of fungal infection in patients with viral pneumonia. High APACHE II scores, tumors, and immunocompromised condition are also important risk factors of developing IPA. The diagnosis of fungal infection in viral pneumonia patients can be facilitated by early serum galactomannan (GM) testing, bronchoalveolar lavage fluid Aspergillus antigen testing, culture, and biopsy.